By the end of 2009 I predict President Barack Obama will sign something that will be touted as health care reform. Whether that something will be classified as universal health care, is yet to be determined.
With a bipartisan coalition of three former Senate majority leaders making their way to Capitol Hill pitching Congress to pass health care legislation, there is unprecedented momentum in the air.
Bob Dole, who led the opposition against former President Bill Clinton's failed health care plan, is now advocating to get something passed this year. Howard Baker compared the current health care debate to the seminal moment when Congress passed civil rights legislation in the 1960s. And Tom Daschle urged that the bill have bipartisan support.
But questions linger.
Can there be a public plan that competes directly with the existing private companies? If so, does that create a climate of unfair competition? Where members of Congress come down on these questions depend on their political philosophy be it liberal, moderate, or conservative.
The other issue is cost. It's hard to believe Congress can pass an effective piece of legislation given the size and scope of what's initially estimated. The preliminary discussions for a health care bill that does more than tinker around the edges is in the range of $1 trillion to $1.5 trillion over 10 years.
The identified $300 billion in cuts to Medicare merely scratches the surface. This reality raises an additional question: Will the politics of the issue allow for the fruition universal health care?
Most experts agree universal health care cannot be achieved unless employer benefits are taxed. But to merely tax the rich doesn't reach the requisite dollars for a comprehensive plan. Therefore, the president would also need to tax middle-class workers.
But this goes against one of the president's campaign pledges. It is common knowledge, especially among his opponents, that candidate Obama promised not to raise taxes on the middle class.
Proponents of universal health care should welcome the contrarian questions; it is the only way to avoid being under the illusion their position is immune from its own set of downsides that require difficult choices.
But there is also a bitter irony to the health care debate. Why is it on matters of life we are justifiably cautious, but on matters of death we are much more cavalier?
Imagine if the run up to the Iraq invasion and occupation was carried out in a similar manner to the ongoing health care debate. What if there was a legitimate attempt to have a bipartisan consensus -- as the former Senate Majority Leaders advocated for health care reform -- that did not shy away from asking the tough questions on Iraq?
According to the National Priorities Project, by the end of FY 2009, the cost for Iraq and Afghanistan will exceed $907 billion -- an amount that in less than 10 years rivals the anticipated cost for universal health care. Iraq as a stand-alone is expected to exceed $700 billion this year.
We're bleeding money that leads to carnage and it is hardly mentioned. But many of those who gave bombastic speeches on the Senate floor that jettisoned our young men and women into harm's way are now concerned about the cost to ensure that all Americans have access to health care.
Tough choices notwithstanding, the questions raised about health care come down to political will. Do Congress and the president have the will to make this potentially groundbreaking legislation law?
If so, tough choices can't be avoided. Universal health care will probably not result in an equitable system. And raising taxes only on the rich won't get it done.
The president must go to the American people and courageously explain why he must renege on his campaign pledge -- that the view from the campaign trail as the Democratic Party's presidential nominee is very different from the one in the Oval Office that must transcend political affiliation.
If the president fails to do this, we may have reform, but it will not be universal health care.
To fully appreciate the different emphasis we place on matters of life and death, in the time required to read this column we dedicated roughly $800,000 to our war efforts.
Byron Williams is an Oakland pastor and syndicated columnist and blog-talk radio host. He is the author of Strip Mall Patriotism: Moral Reflections of the Iraq War. E-mail him at byron@byronspeaks.com or visit his website: byronspeaks.com